Spores are metabolically dormant microbes that remain viable under a wide range of environmental conditions. Spores are typically heat-, acid-, and desiccation-resistant and can persist in the environment for years. Because of their stability, contamination by spores is very common in hospital, clinical, long-term care or nursing home environments. Often, it can be cultured from almost any surface in a hospital. Patient-to-patient transmission of spores occurs by sharing the medical equipment or facilities in hospitals, nursing homes, and other extended-care facilities. Transmission in community settings also occurs.
Given the pathogenesis of various spore-forming microorganisms, judicious use of antibiotics and strict infection control and environmental measures are keys to the prevention and outbreak of disease. The implementation of antibiotic stewardship programs has been associated with decreased incidence of spore related diseases. To prevent spread of spores, environmental cleaning and patient isolation are needed. Several disinfectants commonly used in hospitals may be ineffective against spores, and may actually promote spore formation.
For example, Clostridium difficile, also known as “CDF/cdf”, or “C. diff”, a species of gram-positive, spore-forming anaerobic bacillus, can lead to severe complications ranging from antibiotic-associated diarrhea to severe life-threatening pseudomembranous colitis, a severe infection of the colon. In fact, C. diff. is the cause of approximately 25 percent of all cases of antibiotic-associated diarrhea. Most cases of C. diff. associated disease occur in hospitals or long-term care facilities causing more than 300,000 cases per year in the United States alone. The total US hospital costs for C. diff. associated disease management have been estimated to be $3.2 billion per year.
Health care workers should avoid using only alcohol hand sanitizers, especially in C. diff outbreaks, because alcohol is not effective at killing spores. Due to their resistant nature, spores are very difficult to eliminate with standard measures. Consumer and health care applications are taking measures with large amounts of harsh chemicals including ethylene oxide, aldehydes and highly reactive oxidizing agents such as peracetic acid, chlorine dioxide and ozone which are either carcinogenic or corrosive. It would be virtually impossible to use the current technologies/tactics on skin and delicate devices or surfaces. There is a need to develop a sporicide disinfectant that is nonharmful to human skin and the environment but still provides the sporicidal efficacy.